| Pharmaceutical Company | SmithKline Beecham |
| Program Address | SB Access to Care Program PO Box 2564 Maryland Heights MO 63043 |
| Toll Free Phone Number | 800-546-0420 (Pts) |
| Fax Number | n/a |
| Guidelines and Notes | Call between 7:30-5:30 Central Time and request an application packet. They will 20 at a time, once every 30 days. Products must be for a medically appropriate use. Income must be less than $25,000. Patients must be legal US residents and not be fully covered by insurance (private or government) and the physician making application must believe that if the patient doesn't get the medicine it will result in either noncompliance or a worsening of their condition. |
| Initiating Enrollment | Healthcare provider must call; it is a carbonless form and it CANNOT be copied. |
| Health Provider's Role | Doctor completes, signs, ATTACHES RX and sends. |
| Patient's Role | Minimal information required, would be on-file already. PATIENT SIGNATURE REQUIRED. |
| How Dispensed | Medication is shipped via Fedex to the patient or to the address designated by the physician. |
| Amount Dispensed | All drugs except Paxil, a 90 day supply. For Paxil, initial supply is 30 days, then they will provide refills in 90 day increments. |
| Refills | Use entirely new application, just like first time. |
| Limit | Indefinite |